Pulsed Doppler echocardiographic assessment of patterns of venous flow after the modified Fontan operation: potential clinical implications
| Autor: | Renate Kaulitz, Ingrid Luhmer, Hans Carlo Kallfelz |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Heart Defects
Congenital Male medicine.medical_specialty Adolescent medicine.medical_treatment Diastole Anastomosis Doppler echocardiography Fontan Procedure Hypoproteinemia Liver Function Tests Internal medicine Respiration medicine Humans Expiration Child Cardiac catheterization Echocardiography Doppler Pulsed medicine.diagnostic_test business.industry Central venous pressure Infant General Medicine medicine.disease Blood Coagulation Factors Surgery Child Preschool Pediatrics Perinatology and Child Health Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiology in the Young. 8:54-62 |
| ISSN: | 1467-1107 1047-9511 |
| DOI: | 10.1017/s1047951100004637 |
| Popis: | To assess the effect of a modified Fontan operation on systemic venous blood flow and the hepatic circulation, we compared 11 patients having an atriopulmonary connection and 35 with total cavopulmonary anastomosis. The Doppler echocardiographic study of the caval venous, hepatic venous and portal venous flow was performed so as to calculate the pulsatility ratio and the variation of flow with respiration. All patients had undergone cardiac catheterization. In addition, we included specific laboratory investigations to assess function of various organs.Significantly lower maximum velocities of flow at inspiration (0.31±0.12 rn/sec vs 0.45±0.14 m/sec) and expiration (0.23±0.09 rn/sec vs 0.32±0.11 m/sec), less pulsatility (0.43 vs 0.16) and a lower ratio of systolic to diastolic velocity (1.22 vs 1.85) were found in the patients having a cavopulmonary as compared to an atriopulmonary anastomosis. Peak velocities of hepatic venous flow during inspiration and expiration were significantly lower in those with a cavopulmonary anastornosis (p=O.OOl and pThe dependence of hepatic venous flow on respiration in the presence of a chronically elevated systemic venous pressure in patients after the total cavopulmonary anastornosis may influence hepatic function in the postoperative period. |
| Databáze: | OpenAIRE |
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